SURGERY ACUTE APPENDICITIS EXAM
QUESTIONS AND ANSWERS
What investigations may be helpful in appendicitis and what might they show? -
Answer-BED
- urinalysis to exclude UTI
- pregnancy test to exclude ectopic
BLOOD
- FBC: may show mild leukocytosis
- CRP: may be elevated
IMAGING
- US: may be helpful to visualise appendix mass/abscess
- CT: v sensitivity and specific; has lower rate of negative appendectomies. May show
enlarged appendix with wall thickening and peri-appendiceal fat stranding.
OTHERS
- explorative laparoscopy
Why is it especially important to detect appendicitis early in young women? - Answer-
Perforation may lead to impaired fertility later in life.
How is appendicitis diagnosed? - Answer-Mainly clinical diagnosis but CT abdo pelvis
with PO contrast is becoming increasingly common as a reliable diagnostic test.
How is appendicitis managed? - Answer-1) Appendicectomy (increasingly done
laparoscopically)
2) Antibiotics (also pre-operatively)
3) IV fluids + opiate analgesia
Is laparoscopic or open appendectomy the superior approach? - Answer-1)
Laparoscopic has diagnostic & therapeutic advantages if surgeon experienced -
especially in women & obese.
2) It is NOT recommended in cases of suspected gangrenous perforation as rate of
abscess formation may be higher.
What are the two incisions that can be seen when a laparotomy is performed for
appendicitis? - Answer-5) Lanz incision
or
3) Gridiron incision
What are the complications of appendicitis? - Answer-1) Perforation: esp. in elderly &
young children
QUESTIONS AND ANSWERS
What investigations may be helpful in appendicitis and what might they show? -
Answer-BED
- urinalysis to exclude UTI
- pregnancy test to exclude ectopic
BLOOD
- FBC: may show mild leukocytosis
- CRP: may be elevated
IMAGING
- US: may be helpful to visualise appendix mass/abscess
- CT: v sensitivity and specific; has lower rate of negative appendectomies. May show
enlarged appendix with wall thickening and peri-appendiceal fat stranding.
OTHERS
- explorative laparoscopy
Why is it especially important to detect appendicitis early in young women? - Answer-
Perforation may lead to impaired fertility later in life.
How is appendicitis diagnosed? - Answer-Mainly clinical diagnosis but CT abdo pelvis
with PO contrast is becoming increasingly common as a reliable diagnostic test.
How is appendicitis managed? - Answer-1) Appendicectomy (increasingly done
laparoscopically)
2) Antibiotics (also pre-operatively)
3) IV fluids + opiate analgesia
Is laparoscopic or open appendectomy the superior approach? - Answer-1)
Laparoscopic has diagnostic & therapeutic advantages if surgeon experienced -
especially in women & obese.
2) It is NOT recommended in cases of suspected gangrenous perforation as rate of
abscess formation may be higher.
What are the two incisions that can be seen when a laparotomy is performed for
appendicitis? - Answer-5) Lanz incision
or
3) Gridiron incision
What are the complications of appendicitis? - Answer-1) Perforation: esp. in elderly &
young children
